June 1, 2010 — It may come as a surprise to many people that the comprehensive national health care reform bill signed into law in March contains a substantial piece on prevention and public health, including incentives to prevent chronic disease. The senior leader responsible for that section, Senator Tom Harkin from Iowa, is a long-time health and wellness policy advocate who also literally put the word “prevention” in the Centers for Disease Control and Prevention.

For these efforts and more, Senator Harkin was honored by the Harvard School of Public Health’s Nutrition Round Table with its Healthy Cup Award. The award was presented on Monday, May 17, 2010 as part of a lecture by Harkin and reception at the school.

Senator Harkin has shown “tremendous leadership over the years, putting wellness and health on the American agenda,” said Walter Willett, chair of the HSPH Department of Nutrition, who presented the award. In September 2009, Harkin succeeded the late Senator Edward Kennedy as chair of the Health, Education, Labor and Pension oversight committee.

“We couldn’t have asked for a better person to follow in this important role,” Willett said.

The Healthy Cup honors Harkin specifically for his leadership in developing policies that support and promote good nutrition, healthier lifestyles, and disease prevention, according to the citation. The award also notes his efforts to address obesity issues in children, cardiovascular disease, women’s health issues and much more in efforts to lead the way towards a healthier country.

The plane ride to Boston took only 70 minutes, but the journey to win the prestigious award took “a couple of decades,” said Harkin, who reviewed a wide-ranging array of initiatives beginning with his 1992 presidential campaign platform on health care. He focused on prevention to reign in rising Medicare expenses. “We spend colossal sums fixing people up and peanuts on prevention,” he said. “Not too many people picked up on that then.”

Over the years, Harkin said, he made some headway and ran into surprising opposition. In the 1996 farm bill, his amendment to take vending machines out of schools ran into resistance from a national parent-teacher organization, whose members use the money to support other programs, such as band uniforms. Eventually, they all compromised on putting healthier food and drinks in vending machines.

Bypassing vending machines altogether, Harkin recently expanded the Fresh Fruit and Vegetable Program that he initiated. Overcoming early opposition, the program has been giving free fresh fruits and vegetables snacks to low-income children in schools. The 2008 farm bill provided $1 billion over the next ten years, which will allow it to serve as many as 3 million low-income children.

“This is just getting going,” said Harkin, who next wants to add a provision to allow schools to buy locally grown fruits and vegetables and locally raised meat.

The new health care reform bill goes beyond providing access to health care to support healthful lifestyles and to prevent chronic disease, he said. “The United States spends two times as much per capita on health care than European countries and yet we’re two times as sick with chronic diseases,” Harkin said. “The problem is we have a disease management system that waits until people get sick and spend millions on them.”

At the federal level, the Prevention and Public Health section of The Patient Protection and Affordable Care Act creates a new inter-agency council to develop a national health strategy integrated into every jurisdiction, including planning bike paths and walking paths with new money for roads. At the clinical level, the Act supports doctor training and coverage of preventive services, and it eliminates co-pays and deductibles for these services. At the grassroots level, the Act provides grants to develop more walkable communities, healthier schools and increased access to nutritious foods in safe environments.

In a bipartisan compromise, the legislation also promises mandatory disclosure of calories on menus and menu boards to help reduce rising obesity rates by enabling Americans to make healthier food choices, Harkin said.

“We are no longer voices in the wilderness,” Harkin said, also citing First Lady Michelle Obama’s initiative to fight childhood obesity.

Looking ahead, Harkin said he hopes to reinstate federal authority to regulate unhealthy food advertising to children as inherently unfair, a power removed in legislation passed in 1981. “The Federal Trade Commission has more power to regulate advertisements to you than ads to your kids,” he said. “For adults, the FTC can regulate on deceptiveness and unfairness. For kids, they can only do deceptiveness.”

The Healthy Cup Award is presented by the HSPH’s Nutrition Round Table, a group that helps to bridge the gap between scientific advances and sustainable changes in food policy, practices, and products, with a focus on obesity, healthy lifestyles, global nutrition, and chronic diseases. Its volunteer members are committed to moving nutrition research into practice and include scientific experts, business leaders, restaurateurs, health educators and health care providers, writers, doctors, philanthropists, and concerned citizens.

The Round Table takes superb research the next step to translate it so the fruits of knowledge lead to better practices and better policies improving the health of people, said HSPH Dean Julio Frenk.

Harkin is the third winner of the Healthy Cup Award, which is presented every other year. The first winner in 2006 was Lee Iacocca, who was honored for his philanthropic efforts to accelerate diabetes research and his efforts to introduce healthy food products made without trans fat into the mainstream American diet. In 2008, Kenneth Cooper, was honored for his dedication to understanding the scientific link between exercise and good health. His best-selling book, Aerobics, introduced a new word to the American lexicon and spurred a fitness revolution.